On the heels of a local hospice executive alleging Medicare waste and abuse here in Central Florida, we are seeing similar allegations throughout the country.
Another CFO blew the whistle on another hospice just 80 miles west in Pasco County. In fact, a headline in last week's St. Petersburg Times — "Whistleblower Lawsuit Alleges Billing Abuses …" — could have just as easily run in the Orlando Sentinel.
And both of these stories come on the heels of even more shocking allegations elsewhere — including one near Philadelphia where federal officials accused a hospice exec of spending tax money that was meant for dying people on a luxury car and his own child's college tuition.
These stories may not be the norm. But we're seeing them far too often — the result of lax federal oversight.
A phrase like "Medicare fraud" may conjure up images of a grifter bilking the system on behalf of a fictional beneficiary or two. But that's nothing compared to the systemic fleecing that white-collar executives perpetrate on taxpayers with a government that has been far too willing to look the other way.
For decades, fleecing taxpayers was just part of the game.
The economy was humming along. Tax rates were low. So if health-care companies discovered creative billing policies — whether that meant asking three doctors to look at a patient who probably needed only one or two — nobody really seemed to care. That's what insurance and taxpayers were for — to pay the bill.
But now, with the economy foundering and health-care costs soaring, the government and private insurers are finally paying the kind of attention they should have paid all along.
Attorney General Pam Bondi's office confirmed this week that it is formally investigating the case in Pasco — and closely monitoring developments in Central Florida as well.
In the case of hospices, the accusations generally go like this:
A hospice will identify someone that is old and infirm — but not necessarily dying — and tap into Medicare money to help pay their bills at a rate of $140 a day and up.
Doug Stone, the former CFO of Hospice of the Comforter, said that officials here would sometimes keep these patients on hospice care — and the Medicare payroll — for years, obviously suggesting they weren't in the final stages of life.
And then, Stone said, when questions started being asked, Hospice would release patients after declaring them "no longer terminally ill."
In one memo, Stone said the agency had declared 133 patients "no longer terminally ill" — a number so large it sounds more like a tent revival.
Hospice denies any wrongdoing.
And at this point, I want to be clear that none of these accusations mean that hospices around this country haven't provided excellent care.
When done properly, hospice care can be truly magical — providing comfort and care to the dying, allowing a potentially tragic time to be both appreciated and even spiritual. Hospice of the Comforter has provided just such care for thousands of people, which is why I've championed its cause in years past.
But stellar care on the front lines doesn't excuse financial shenanigans, especially when taxpayer money is involved.
And some parts of the story at Hospice of the Comforter — such as $200,000 worth of bonuses to CEO, tied partly to patient counts — aren't in dispute.
We need answers and full accountability.
As former hospice nurse Elly Barton told the Sentinel last week, caring for the dying is one thing. But tapping into tax dollars for people who are well enough to cook and drive for years at a time is quite another.
Said Barton: "This is my money, too. I'm on Medicare, and I don't want the system to be abused."
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